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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >The role of transcranial Doppler ultrasound monitoring in patients with aneurysmal subarachnoid haemorrhage
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The role of transcranial Doppler ultrasound monitoring in patients with aneurysmal subarachnoid haemorrhage

机译：经颅多普勒超声监测在动脉瘤性蛛网膜下腔出血患者中的作用

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摘要

The effect of transcranial Doppler (TCD) ultrasound monitoring of vasospasm on patient management following aneurysmal subarachnoid haemorrhage (aSAH) remains unclear. We reviewed our departmental use of TCD by retrospectively analysing 152 medical records. Results of investigations and management changes, including frequency of neurological monitoring and changes in triple H therapy, were examined. TCD monitoring occurred in 87 patients (57%) by untrained neurosurgical registrars. There was high variability in the number of operators for each patient (over 50% of patients had more than two different operators), insonation protocol and monitoring duration (at least 50% of patients were monitored for fewer than seven days). TCD results influenced management in only 18 (12%) patients, while clinical deterioration or improvement dictated more than 80% of changes in triple H therapy and neurological monitoring. Prospective validation in similar neurosurgical settings is needed to justify continued usage of TCD monitoring. Formal training for operators and a standard monitoring protocol should also be considered to increase TCD utility. Prospective evaluation of TCD at our centre has recently been completed.
机译：经颅多普勒（TCD）超声监测血管痉挛对动脉瘤性蛛网膜下腔出血（aSAH）后患者管理的影响尚不清楚。我们通过回顾性分析152份病历，回顾了我们部门对TCD的使用情况。检查和管理变化的结果，包括神经系统监测的频率和三重H疗法的变化。未经训练的神经外科注册员对87例患者（57％）进行了TCD监测。每个患者的操作员数量（超过50％的患者有两个以上不同的操作员），声像记录方案和监测持续时间（至少50％的患者接受少于7天的监测）存在很大差异。 TCD的结果仅影响18名患者（12％）的治疗，而临床恶化或改善决定了三联H疗法和神经系统监测变化的80％以上。需要在类似的神经外科手术环境中进行前瞻性验证，以证明继续使用TCD监测是合理的。还应考虑对操作人员进行正式培训并制定标准的监测规程，以增加TCD的实用性。我们中心对TCD的前瞻性评估最近已经完成。

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